Provider Demographics
NPI:1720359235
Name:WELCH, ROBERT F (MS, ATC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:F
Last Name:WELCH
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 BUCKINGHAM AVE
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23228-6030
Mailing Address - Country:US
Mailing Address - Phone:508-272-2292
Mailing Address - Fax:
Practice Address - Street 1:8201 ATLEE RD
Practice Address - Street 2:SUITE D
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-1815
Practice Address - Country:US
Practice Address - Phone:804-569-1787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-16
Last Update Date:2012-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260011252255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer